Division of Pediatrics.
Department of Pediatric Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
J Pediatr Hematol Oncol. 2022 Mar 1;44(2):e589-e592. doi: 10.1097/MPH.0000000000002226.
Neuroblastoma with bone metastasis is well known to have an extremely poor prognosis. We experienced the case of a patient with adrenal ganglioneuroblastoma (GNB) with metastases of subcutaneous nodules, a lymph node, and multiple bones. A pathologic examination of tumors from different sites revealed both GNB and ganglioneuroma. A genetic comparison between these tumors identified the same molecular signatures, suggesting the possibility of spontaneous differentiation in the remaining GNB. The patient has been healthy without aggressive chemotherapy, and the patient's pathologic urinary catecholamines normalized. Even if unusual, we have to recognize probable spontaneous differentiation from neuroblastoma to GNB and then to ganglioneuroma, even in sites of bone metastasis.
神经母细胞瘤伴骨转移预后极差已广为人知。我们遇到了 1 例发生于肾上腺的节细胞神经母细胞瘤（ganglioneuroblastoma，GNB）伴皮下结节、淋巴结及多处骨转移的病例。不同部位肿瘤的病理检查均显示 GNB 和神经节细胞瘤。对这些肿瘤进行的基因比较确定了相同的分子特征，提示剩余 GNB 中可能存在自发分化。该患者未经强烈化疗，身体状况良好，患者的病理尿儿茶酚胺恢复正常。即使这种情况不常见，但我们必须认识到，即使在骨转移部位，也可能有从神经母细胞瘤到 GNB 再到神经节细胞瘤的自发分化。
